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Ethicists Explain Worst-Case Scenario Policies While Exercising Caution
Clinicians nationwide suddenly have multiple urgent concerns on hypothetical COVID-19 scenarios. They are turning to ethicists for answers. At a Missouri-based system, ethicists are working on policies regarding balancing the public good with patients’ right to leave against medical advice, critical care allocation, and modified visitation.
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Ethical Policies if Critical Care Resources Become Scarce
If and when there are not enough ventilators for all the COVID-19 patients who need them, hospitals can expect lots of public scrutiny. Clear, consistent, and transparent policies can make the ethical rationale behind decisions obvious to everyone.
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COVID-19 Response: From Panic to Complacency
Even as the COVID-19 pandemic virus rages in some areas of the United States, there has been marked complacency in others, where public health pleas to stay at home and practice social distancing have been ignored by some.
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All Eyes on Ethics: Pandemic Means ‘Shift from Status Quo’
The diverse backgrounds of clinical ethicists have strengthened COVID-19 responses at many hospitals. Patients and family, clinicians, and administrators are turning to ethics for help.
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The Forecast Calls for Pain
There is the proverbial glass half-full or half-empty — and then there is the cold shot of despair that comes with considering how much of the planet COVID-19 has yet to hit.
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Personal Protective Equipment Shortage Is ‘Simply Unacceptable’
Two different national surveys have found widespread shortages of personal protective equipment and other critical hospital supplies as the United States battles the highest number of COVID-19 cases in the world.
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Many Serious Cardiac Complications of Pregnancy Are Preventable
Investigators determined about half of serious cardiac complications of pregnancy are preventable.
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Coronary CT Angiography to Identify Plaque Stabilization
Researchers identified subjects with no known coronary artery disease drawn from a large international, multicenter registry of coronary CT angiography. Subjects were divided into matched pairs with and without a subsequent acute coronary syndrome event. The authors demonstrated those with a high density of calcium plaques experienced the fewest events, suggesting high-density calcium plaques are stable.
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TAVR in Bicuspid Aortic Valves
Investigators assessed the Society of Thoracic Surgeons/American College of Cardiology transcatheter aortic valve replacement (TAVR) data, with a focus on the use of newer TAVR devices in patients with bicuspid aortic valve vs. tricuspid aortic valves. They found the outcomes post-procedure and for one year are not significantly different between the two types of native valve anatomy. -
Antiplatelet Agents Add to Bleeding Risk, Do Not Add Benefit in TAVR Patients Already on Oral Anticoagulation
In a randomized trial of patients already on anticoagulation undergoing transcatheter aortic valve replacement, adding clopidogrel to oral anticoagulation increased the incidence of serious bleeding vs. oral anticoagulation alone, but did not improve cardiovascular outcomes.